Research in Women’s Health

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 Outline
• What is Research?
• Research in Ethiopia
• Research in Women’s Health
• Opportunities and challenges

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 Research
• Research is a quest for knowledge through
diligent search or investigation or
experimentation aimed at the discovery and
interpretation of new knowledge.
• Scientific method is a systematic body of
procedures and techniques applied in carrying
out investigation or experimentation targeted
at obtaining new knowledge.

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 Categories of research
• Empirical and theoretical research
(philosophical)
• Quantitative versus qualitative research
• Basic and applied (functional)
• Health research triangle
– Biomedical
– health services
– behavioral

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 Study design

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 Health Research in Ethiopia
• Health is a fundamental prerequisite to
human development.
• Evidence based strategies for effective health
interventions emanate from a representative,
ethical and rigorously conducted health
research.

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 Health … cont’d
• Health research undertakings
– Researchers
– research funders and research users
– the presence of detailed laws and regulations
conducive for undertaking health research
• History of health research in Ethiopia spans
nearly seven decades.

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 Health … cont’d
• The number of health researchers, research
institutes and volume of research output so
far is small.
• Detailed laws and regulations pertaining to
health research are not enacted and
governance of health research is not clearly
articulated.

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 Health … cont’d
• There are global, regional and programmatic
inequities in the national health research
arena.
• Evolution of the health research in the country
into an organized "National Health Research
System" is still at an early stage.

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 Research in Women’s Health in Ethiopia
• health problems for Ethiopia’s women:
– harmful cultural practices
– shortages of health workers
– resource constraints
– low rates of literacy
• the world’s lowest sexual and RH indicators.
– The MMR is 671 per 100 000 live births
– fertility rate: of the highest in the world
– modern contraceptive use is only about 14%.
– One out of every 27 women dies during child birth
– only 28% of women receiving ANC

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 Research in … cont’d
• The HSDP addresses issues such as
women's maternal health, HIV/AIDS, and malaria.
• Several components of the program target
women:
– establishment of women's affairs departments in
the health service
– awareness-raising on gender issues within health
workers
– increasing the utilization of health services by
women.

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 Research … cont’d
• But The MOH allocations for women-specific
issues are also small and have decreased over
the past three years.
• The expansion and strengthening of
women's affairs program amounted to 0.01%
of the entire 2008/09 health budget.
• Family planning and reproductive health
programs attracted a larger share, around
10% of the total health budget.

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 Research … cont’d
• More precise knowledge about women’s
health is vital for Ethiopia as a whole
• The key for developing an endogenous health-
care system is to twin research with the
practice
– practice generates new understandings
– the understanding leads to new practices

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 Research … cont’d
• the contributory role of formal health services
to the poor national status of maternal and
neonatal health
– a pool of literature exists highlighting the
inadequacy of health systems and infrastructure,
including the lack of skilled health care providers.
• However, there is less available information
from the users of the health system.

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 Opportunities
• The Sustainable Development and poverty Reduction
Program (SDPRP)
• The quest for Good Governance and Decentralization
• Comprehensiveness of the HSDP
• Health Service Extension Program
• Expansion of Training institutions
• Growing Size of the Private Sector
• Capacity Building strategy and program
• Utilize the HIV/AIDS Fund
• Supporting policies for MCH service

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 Global Health Initiative
• Vision: Maternal Health: Save approximately
360,000 women’s lives by reducing maternal
mortality by 30 percent across assisted countries
• Principle: Implementing a woman- and girl-
centered approach
• Conducting implementation research to provide a
local and international evidence base to inform
decision-makers to develop policies and
programs that lead to broad sweeping public
health improvement.
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 UNGASS
• A Joint Plan of Action for Women’s and
Children’s Health: Saving 16 million Lives

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 Challenges … cont’d
• in order to understand the magnitude and
burden of disease, there is a need to move
beyond global estimates to counting every
pregnant woman, mother and newborn.
– This requires solid M&E systems capable of
generating evidence for action.

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 Challenges … cont’d
• Inadequate utilization of the data resulting
from the surveillance system
• Insufficient dissemination of results to
relevant agencies.
• unidirectional data flows; poor supervision
and management, analysis and feedback,
resulting in low quality of routine MIS data.

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 Challenges … cont’d
1. health research values
– Equity
– Ethics
2. Research Environment
– Globalization
– Inadequate resources
– Research culture

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 Challenges … cont’d
3. Sustainable Health Research Systems
– Plurality of stakeholders (governance)
– Strengthening research capacity
– Maintaining stable financing
4. Knowledge Production and Application
– Knowledge application
– Knowledge as public good

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 References
1. Mahmoud F. Fathalla. A Practical Guide for Health Researchers. 2004. WHO
2. WORLD HEALTH ORGANIZATION. HEALTH RESEARCH METHODOLOGY. A Guide for Training in
Research Methods. Second Edition. Regional Office for the Western Pacific. Manila, 2001
3. Implementation of the Global Health Initiative: Consultation Document. Washington DC, 2010.
4. A Joint Plan of Action for Women’s and Children’s Health: Saving 16 million Lives. Note on
Securing Commitment and Pledges to the Joint Plan of Action at the Country-Level. New York,
September 2010.
5. Monitoring and Evaluation of Maternal and Newborn Health and Services at the District Level
:Technical Consultation Meeting Report. 5–8 December 2006. Department of Making Pregnancy
Safer. World Health Organization
6. Evaluation Report of the Making Pregnancy Safer Strategy in Ethiopia. Family Health
Department Federal Ministry of Health. Addis Ababa, Ethiopia January/2005
7. Victoria Rumbold, Charlotte Warren and Yared Amare. FINAL REPORT ON THE SAFE
MOTHERHOOD COMMUNITY-BASED SURVEY, ETHIOPIA.
8. Wairagala Wakabi. Research collaboration boosts women’s health in Ethiopia. the Lancet. 372
(1) 2008
9. WHO. Strategies for Health Research System Development in South East Asia Region. The Fifth
Fourth regional Committee of South East Asia Region. Provision Agenda item 5. 28 August,
2001
10. Gaym A. Health research in Ethiopia--past, present and suggestions on the way forward. Ethiop
Med J. 2008 Jul;46(3):287-308.

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